Frances Dare, director of the health-care consulting practice for the Cisco Internet Business Solutions Group. Dare recently testified on Capitol Hill and has advised the Obama administration regarding the stimulus package. She has spent more than 25 years in the health-care industry as a hospital administrator for two facilities.

Phil Fasano, CIO at Oakland, Calif.-based Kaiser Permanente, a $38 billion nonprofit health-care system. Kaiser Permanente offers health care services through a network of nearly 14,000 physicians at Permanente Medical Groups; 32 medical centers and more than 400 medical offices that form the Kaiser Foundation Hospitals; and the Kaiser Foundation Health Plan, which has 8.7 million members. Kaiser is finishing up a 5-year EHR system implementation that cost $5 billion and created 5 petabytes of data on spinning disk serving 32 hospitals, more than 400 medical clinics and 14,000 physicians.

The following is an edited version of those interviews.

How will the billions of dollars help spur adoption, particularly when you consider many small hospitals and physician practices have not even begun an EHR rollout?

Kennedy: Well, that's where the challenge is. If you look at the penetration of [electronic medical records], they're highest where there's enough of a facility there to be able to support the infrastructure costs. When you look at solo and small physician groups, which still represent the majority of how physicians practice, we are going to have to take advantage of the inherent scalability of the Internet as well as some of the existing infrastructure.